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(Rock n') Roll onto backboard

post #1 of 11
Thread Starter 
Another one of those pesky newbie questions:

I just finished the CSPS course and one of the things the intructors had different preferred methods for was the arm position when rolling someone onto a backboard.
Keep the guy's arm along his body, so when you roll him onto his side he has the added height of the arm, making it easier to slide the backboard into position - which is probably pretty uncomfortable (actually it hurt like the dickens, but due to the 'learning process' and newbies at work etc, I ended up lying on my arm for the better part of 10 minutes).
Or lift the arm up and out of the way before rolling - which seems to be more common (?).
post #2 of 11
We were taught, "on roll side arm, above the head". Since we're rolling to keep the patients spine aligned on the board, having the arm buried is just going to add additional twist (or is it torque?) and bending of the spine due to the exact thing you mention, the added height. Plus, in addition to being damned uncomfortable, it's also pretty destabilizing since any arm movement will result in the px moving about laterally, which is exactly what you don't want.

I say "don't do it".

But what do I know...I'm a newbie too!
post #3 of 11
Quote:
Originally Posted by airshowguy View Post
We were taught, "on roll side arm, above the head". Since we're rolling to keep the patients spine aligned on the board, having the arm buried is just going to add additional twist (or is it torque?) and bending of the spine due to the exact thing you mention, the added height. Plus, in addition to being damned uncomfortable, it's also pretty destabilizing since any arm movement will result in the px moving about laterally, which is exactly what you don't want.

I say "don't do it".

But what do I know...I'm a newbie too!
More than you think. Every situation is different but you are on the right track.
post #4 of 11
A couple of things, you need to read the book and do what the book says to do. I believe the book subscribes to the arm above the head. Remember if you are in court and somebody says how were you trained you will say, "well some guy told me...." how do you think that would fly.

But, I have to admit I subscribe to the arm under method. It allows the torso to be raised enough to get the board under the person so that when you roll back down the person is more aligned to the center of the board. Remember the goal is to get person on the board with as little movement as possible. You don't want the person to be hanging off the side of the board (which is more likely with the arm above head position,) and have to do 2-3 inline drags to get the person positioned.

Also if you do choose to roll with arm by the side and you have a person up on arm for more than 10 seconds, you should transfer to safety patrol.

Going back back to beginning, read the book.
post #5 of 11
Thread Starter 
Quote:
Going back back to beginning, read the book.
RTFM, right?

The book advises arm above the head, but I admit I'm always looking for insight from experienced patrollers/EMTs/etc... for myself mostly. Occasionally experienced patrollers have improved the methods in the book (small things mostly, like non-slip knots for splinting instead of having the patient 'hold a finger' on your knot). I think it's good to be aware of these options; real life situations can get a lot more convulted then the examples in the manual and I'd imagine that the more information you have amassed (be it from the manual or other sources), the more effective you can be.
Of course, I've never provided first aid to anyone, so what the hell do I know? In all other situations in my life though I've always applied the mentality that you should always read the manual, but use your head - if that's not desireable, then robots should take over .

Off topic thought: If it doesn't freakin' start snowing already (blasted Ontario weather) I'm gonna have to quit my job, sell everything and 'Go West' (as the Pet Shop Boys so nicely put it). I did not cram the CSPS manual to sit on my ass and watch the local fauna frolic in the grass. :
post #6 of 11
Quote:
Originally Posted by jinx View Post

Off topic thought: If it doesn't freakin' start snowing already (blasted Ontario weather) I'm gonna have to quit my job, sell everything and 'Go West' (as the Pet Shop Boys so nicely put it). I did not cram the CSPS manual to sit on my ass and watch the local fauna frolic in the grass. :
And your in freaking Canada. If your thinking of moving west what hope do us poor yankees have to get any cold weather?
post #7 of 11
I've seen and done it both ways as an Wilderness First Responder and more recently as and EMT. I find the arm gets in the way underneath and has a tendancy to shift all over the place losing any of the stability you were trying to gain in the first place. If the arm is up by the head, it provides stability for the C-Spine (w/ or w/o collar) and if you so please, you can logroll the patient by yourself if you put both arms above the head, providing some C-Spine stabalization. I recomend trying that one on a healthy non-injuried individual first. If the person is not centered on the board, I beleive in some areas protocall says you can push the patient sideways along the board in a uniform manner if you have enought people to do so. But moving them in-line is better if there are no imediate life threats.
post #8 of 11
Quote:
Originally Posted by Bryan View Post
You don't want the person to be hanging off the side of the board (which is more likely with the arm above head position,) and have to do 2-3 inline drags to get the person positioned.
So, what we were taught was the traditional positioning of the patient before rolling onto the board is wrong and typically results in 2 or 3 inline drags.

The newer technique being taught to EMT's and Advanced Life Support people in the St. Louis area (and perhaps wider) is to position the px with the roll-to arm above the head and position the backboard with the headcushions about one head length above the top of the patient's head. Once rolled onto the board, the px will be 1) off center (like they typically are) and 2) about a heads-length too low on the board. However, in this position, one slightly angling inline drag (with no lateral movement) will position the px correctly on the board and will reduce to the bare minimum the number of re-positioning movements required to get them in position for securing and transport.

Anyone else using this "one-head-low" technique?
post #9 of 11
Quote:
Originally Posted by airshowguy View Post
So, what we were taught was the traditional positioning of the patient before rolling onto the board is wrong and typically results in 2 or 3 inline drags.

The newer technique being taught to EMT's and Advanced Life Support people in the St. Louis area (and perhaps wider) is to position the px with the roll-to arm above the head and position the backboard with the headcushions about one head length above the top of the patient's head. Once rolled onto the board, the px will be 1) off center (like they typically are) and 2) about a heads-length too low on the board. However, in this position, one slightly angling inline drag (with no lateral movement) will position the px correctly on the board and will reduce to the bare minimum the number of re-positioning movements required to get them in position for securing and transport.

Anyone else using this "one-head-low" technique?
That's how we're doing it also. positioning the board low, and hopefully only have to do one inline drag up to get them into position.

Quote:
Originally Posted by Korporal
I beleive in some areas protocall says you can push the patient sideways along the board in a uniform manner if you have enought people to do so. But moving them in-line is better if there are no imediate life threats.
I don't think so, with a compromised spine, we are trained to never move laterally unless in conjuction with an in-line drag.
post #10 of 11
Quote:
Originally Posted by airshowguy View Post
So, what we were taught was the traditional positioning of the patient before rolling onto the board is wrong and typically results in 2 or 3 inline drags.

The newer technique being taught to EMT's and Advanced Life Support people in the St. Louis area (and perhaps wider) is to position the px with the roll-to arm above the head and position the backboard with the headcushions about one head length above the top of the patient's head. Once rolled onto the board, the px will be 1) off center (like they typically are) and 2) about a heads-length too low on the board. However, in this position, one slightly angling inline drag (with no lateral movement) will position the px correctly on the board and will reduce to the bare minimum the number of re-positioning movements required to get them in position for securing and transport.

Anyone else using this "one-head-low" technique?

For reference look at page 685 in the 4th edition book,,, step 3 says the patient's arm may be alongside the body or elevated depending on local protocols.

who the hell am I to say what is wrong, however, I find that useing the arm for leverage really eliminates all the dragging. And it just stands to reason the fewer moves the better you are and I believe the Sr Program advocates one move, but Once again, who the hell am I to believe. By the way, positioning the back board 12-14 inches above the head before you roll them on is what I was taught 15 years ago. Isn't it strange how things propagate through the EMS system.
post #11 of 11
Up north of Barrie, we've been doing rolls with the arm in. We've also been teaching the rookies to do some rolls with hands on both sides of the patient, as a lot of our boards are done on unstable/slanted terrain and you need to protect the patient. When we're doing that, you can protect the patient from squeezing onto their arm, and also from shifting which provides better C-Spine support. I've been trying to do more low-board transfers and then slide up, and it's gaining acceptance. blanketing the board can also help greatly for shifting the patient without damage.
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